Massimo Milli

Azienda Usl Toscana Centro

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i-10 index

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Co-Authors

Claudio Bilato

International Renal Research Institute of Vicenza

Leonardo De Luca

Policlinico San Matteo Fondazione

Furio Colivicchi

ASL Roma

Giovanna Geraci

Ospedale Sant Antonio

Massimo Grimaldi

Ospedale Generale Regionale Francesco Miulli

Alessandro Navazio

Tecnologie Avanzate (Italy)

Massimo Di Marco

Ospedale di Santo Spirito

Carmine Riccio

Ospedale Sant'Anna

Vittorio Pascale

Presidio Ospedaliero

Attilio Iacovoni

Ospedale Papa Giovanni XXIII

Cooperative Institutions

University of Florence

Azienda Ospedaliero-Universitaria Careggi

Associazione Nazionale Medici Cardiologi Ospedalieri

Istituti di Ricovero e Cura a Carattere Scientifico

Santa Maria Nuova Hospital

Azienda Usl Toscana Centro

Ospedale Santa Maria

Sapienza University of Rome

Nuovo Ospedale San Giovanni di Dio

University of Padua

Author Statistics

Papers

Citation

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i-10 index

Research Field

B-Type Natriuretic Peptide Can Predict the Medium-Term Risk in Patients With Acute Heart Failure and Preserved Systolic Function

Journal of Cardiac Failure (2005)

Roberto Valle Nadia Aspromonte Mauro Feola Massimo Milli Cristina Canali

10.1016/j.cardfail.2005.05.002

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Citations (56)

[ANMCO Scientific statement on combination therapies and polypill in secondary prevention].

PubMed (2024)

Leonardo De Luca Stefania Angela Di Fusco Gianmarco Iannopollo Raffaella Mistrulli Vittoria Rizzello

The issue of suboptimal drug regimen adherence in secondary cardiovascular prevention presents a significant barrier to improving patient outcomes. To address this, the utilization of drug combinations, specifically single pill combinations (SPCs) and polypills, was proposed as a strategy to simplify treatment regimens. This approach aims to enhance treatment accessibility, affordability, and adherence, thereby reducing healthcare costs and improving patient health. The document is an ANMCO scientific statement on simplifying drug regimens for secondary cardiovascular prevention. It discusses the underuse of treatments despite available, effective, and accessible options, highlighting a significant gap in secondary prevention across different socioeconomic statuses and countries. The statement explores barriers to implementing evidence-based treatments, including patient, healthcare provider, and system-related challenges. The paper also reviews international guidelines, the role of SPCs and polypills in clinical practice, and their economic impact, advocating for their use in secondary prevention to improve patient outcomes and adherence.

Polypill

Statement (logic)

10.1714/4252.42301

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Citations (0)

The relevance of specific heart failure outpatient programs in the COVID era: an appropriate model for every disease

Reviews in Cardiovascular Medicine (2021)

Matteo Beltrami Simone Bartolini Massimo Milli Alberto Palazzuoli

Heart Failure (HF) is characterized by an elevated readmission rate, with almost 50% of events occurring after the first episode over the first 6 months of the post-discharge period. In this context, the vulnerable phase represents the period when patients elapse from a sub-acute to a more stabilized chronic phase. The lack of an accurate approach for each HF subtype is probably the main cause of the inconclusive data in reducing the trend of recurrent hospitalizations. Most care programs are based on the main diagnosis and the HF stages, but a model focused on the specific HF etiology is lacking. The HF clinic route based on the HF etiology and the underlying diseases responsible for HF could become an interesting approach, compared with the traditional programs, mainly based on non-specific HF subtypes and New York Heart Association class, rather than on detailed etiologic and epidemiological data. This type of care may reduce the 30-day readmission rates for HF, increase the use of evidence-based therapies, prevent the exacerbation of each comorbidity, improve patient compliance, and decrease the use of resources. For all these reasons, we propose a dedicated outpatient HF program with a daily practice scenario that could improve the early identification of symptom progression and the quality-of-life evaluation, facilitate the access to diagnostic and laboratory tools and improve the utilization of financial resources, together with optimal medical titration and management.

Etiology

Disease management

10.31083/j.rcm2203077

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Citations (2)

[ANMCO Statement: semaglutide in cardio-nephro-metabolic disorders].

PubMed (2024)

Leonardo De Luca Claudio Bilato Alessandro Navazio Marco Corda Massimo Milli

Semaglutide, a glucagon-like peptide-1 receptor agonist, has emerged as a pivotal therapeutic agent in the management of the cardio-renal-metabolic continuum. Initially developed for glycemic control in type 2 diabetes mellitus, its benefits extend far beyond glucose regulation. Clinical trials have demonstrated semaglutide's potential to reduce major adverse cardiovascular events, particularly in overweight/obese patients with high cardiovascular risk, as well as improving functional capacity in patients suffering from heart failure with preserved left ventricular function. Additionally, it has shown promise in improving renal outcomes, such as slowing the progression of albuminuria and reducing the risk of chronic kidney disease in diabetic populations. These effects are likely due to its multifaceted mechanisms, including anti-inflammatory properties, weight reduction, blood pressure lowering, and direct renal protection. This review synthesizes current evidence on semaglutide's role in the interrelated domains of cardiovascular, renal, and metabolic health.

Semaglutide

Statement (logic)

10.1714/4372.43702

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Citations (0)

The Role of the Left Atrium: From Multimodality Imaging to Clinical Practice: A Review

Life (2022)

Matteo Beltrami L Dei Massimo Milli

In recent years, new interest is growing in the left atrium (LA). LA functional analysis and measurement have an essential role in cardiac function evaluation. Left atrial size and function are key elements during the noninvasive analysis of diastolic function in several heart diseases. The LA represents a “neuroendocrine organ” with high sensitivity to the nervous, endocrine, and immune systems. New insights highlight the importance of left atrial structural, contractile, and/or electrophysiological changes, introducing the concept of “atrial cardiomyopathy”, which is closely linked to underlying heart disease, arrhythmias, and conditions such as aging. The diagnostic algorithm for atrial cardiomyopathy should follow a stepwise approach, combining risk factors, clinical characteristics, and imaging. Constant advances in imaging techniques offer superb opportunities for a comprehensive evaluation of LA function, underlying specific mechanisms, and patterns of progression. In this literature review, we aim to suggest a practical, stepwise algorithm with integrative multimodality imaging and a clinical approach for LA geometry and functional analysis. This integrates diastolic flow analysis with LA remodelling by the application of traditional and new diagnostic imaging techniques in several clinical settings such as heart failure (HF), atrial fibrillation (AF), coronary artery disease (CAD), and mitral regurgitation (MR).

Cardiac Imaging

Dilated Cardiomyopathy

10.3390/life12081191

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Citations (3)

Comparison of long‐term outcome in anthracycline‐related versus idiopathic dilated cardiomyopathy: a single centre experience

European Journal of Heart Failure (2017)

Alessandra Fornaro Iacopo Olivotto Luigi Rigacci M Ciaccheri Benedetta Tomberli

Dilated Cardiomyopathy

10.1002/ejhf.1049

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Citations (61)

[ANMCO Position paper: Functional reorganization of cardiac intensive care units (CICUs) in Italy].

PubMed (2025)

Serafina Valente Paolo Trambaiolo Gianni Casella Alice Sacco Carlotta Sorini Dini

Recently, cardiac intensive care units (CICUs) have undergone a significant transformation related to the evolution in management of acute coronary syndrome and influenced by other factors such as the epidemiological transition, the increasing complexity of clinical cases, the technological advancement, and the growth of clinical and scientific expertise of cardiologists. In the context of this evolution, a functional reorganization of CICUs in Italy has to be implemented in order to meet the changing needs of the population with cardiovascular disease requiring critical care. Therefore, the Italian Association of Hospital Cardiologists (ANMCO) proposes this position paper for the reorganization of CICUs into three levels with increasing functional complexity, based on the hospital characteristics, the available technology, and clinical cases treated. The system would be functionally integrated into a regional CICU organization modeled on a time-dependent care network. This proposed network aims to standardize diagnostic and therapeutic protocols and establish unified data collection registries to facilitate self-assessment and support clinical research. The document delineates specific requirements for each CICU level, including the management of clinical cases, the expertise of intensive care cardiologists, the technological facilities, and the medical and nursing staff needed to ensure optimal care delivery.

Position (finance)

10.1714/4418.44144

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Citations (0)

Clinical impact of smoking on atrial fibrillation recurrence after pulmonary vein isolation

International Journal of Cardiology (2024)

Andrea Giomi Andrea Bernardini Alessandro Paoletti Perini Davide Ciliberti Cristiano Salvatore Zaccaria

Isolation

10.1016/j.ijcard.2024.132342

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Citations (2)

[Role of outpatient heart failure clinics and primary care physicians in the tailored follow-up of heart failure patients]

Giornale italiano di cardiologia (2010)

Renata De Maria Gianfranco Misuraca Massimo Milli Alessandro Filippi

Continuity of care is pivotal to appropriately manage patients affected by heart failure (HF). HF is a chronic disease with frequent exacerbations that requires long-term care at different complexity levels. The lack of adequate communication between hospital cardiologists and primary care physicians (PCPs) is the main pitfall in continuity of care for HF patients. To overcome this problem, all dedicated outpatient HF clinics should organize together with PCPs in the community educational and auditing initiatives, based on locally derived performance measures to assess the appropriateness and effectiveness of integrated care pathways. The primary task of PCPs is to follow up stable HF patients and focus assessment on patient empowerment, adjustment of drug therapy, assessment of clinical stability and the early identification of worsening signs and symptoms. The progress of information technology should help in achieving adequate communication between hospital professionals and PCPs; outpatient clinical records should in any case comply with qualitative standards of discharge summaries for all patients taken in charge by PCPs. Systematic assessment of shared care between hospital cardiologists and PCPs will be a main objective of the outpatient HF clinic network in the near future.

Outpatient clinic

Patient Empowerment

Continuity of Care

Source

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Citations (1)

[ANMCO/GISE/SICOA Consensus document: Role of coronary computed tomography angiography in chronic coronary syndromes].

PubMed (2025)

Pasquale Guarini Francesco Saia Carlo Tedeschi Alessandra Scatteia Edoardo Conte

Chronic coronary syndromes (CCS) are the most common clinical manifestation of coronary atherosclerosis. Coronary computed tomography angiography (CCTA) is a recent innovation in non-invasive cardiac imaging. It is the only anatomical imaging method that allows direct visualization of the coronary lumen, vessel walls, and atherosclerotic plaques, offering high sensitivity and a strong negative predictive value. CCTA is particularly useful in identifying or ruling out coronary atherosclerosis in the context of CCS and serves as an excellent filter for invasive coronary angiography. Compared to other non-invasive functional imaging tests (stress echocardiography, single photon emission computed tomography, magnetic resonance imaging, positron emission tomography), CCTA provides detailed characterization of both obstructive and non-obstructive plaques, enabling accurate risk stratification and guiding therapy. Recent advances in computed tomography technology and imaging techniques further extend the use of CCTA beyond plaque and stenosis evaluation, offering also functional lesion information. This consensus document aims to detail the technical aspects of CCTA and illustrate its role in optimizing CCS diagnostic and therapeutic management, enhancing precision medicine and personalized patient care.

Computed Tomography Angiography

10.1714/4418.44145

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Citations (0)